Acoustic analysis of Korean stop sounds in patients with dysarthrias

Purpose Korean ‘stops’ are considered an especially good acoustic variable since they are sensitive to speech intelligibility and reflect physiological coordination between laryngeal and supra-laryngeal mechanisms. The purpose of the study was to evaluate the acoustic characteristics of both the dysarthria and control groups in the production of nine Korean stops, /p, p′, ph, t, t′, th, k, k′, kh/, in VCV contexts. Methods The participants comprised eight patients with dysarthria and eight age- and gender-matched normal adults. After the acoustic analysis of the closure duration, aspiration duration, and the ratio of closure duration to closure-aspiration combined duration, the results were compared among three types of phonation and places of articulation for Korean stops. Results The dysarthria group (DG) had longer closure durations, suggesting slower articulatory movements of the DG than the normal control group (NC). Although statistically not significant except for /ap′a/ and /at′a/, the absolute aspiration durations of the DG were still longer than those of the NC. This resulted in the normal levels of ratios in the DG between closure duration and closure-aspiration combined durations. Furthermore, the DG could change the durational aspects of stop production distinctively according to types of phonation more than they could according to the places of articulation. This trend was more prominent during the closure duration than during the aspiration duration. Conclusions This finding suggested that while the DG has centralized tongue positions, they control the tenseness and the timing coordination between laryngeal and supra-laryngeal articulators to distinctively produce different types of phonation of stops.ope

음향학적 분석을 통한 노년층 연령에 따른 조음교대운동의 속도 및 규칙성

Aging is related to anatomical and physiological changes in respiratory and phonation organs. These changes influence articulation which leads to inaccurate speech and slow articulatory diadochokinesis(DDK). DDK indicates the range, rate, regularity, accuracy, and agility of articulation that reflect motor speech function. The purpose of this study is to investigate the rates and regularities of DDK in healthy Korean elderly through passive acoustic analysis (Praat). Thirty subjects between the ages of 65 and 94 participated in this study. Rate was observed for 5 seconds, while regularity was calculated based on the standard deviation on the following: 1) syllable duration of each task; 2) gap duration between syllables. Then, simple regression analysis was conducted in order to examine the effect of age on performance. The result showed that the slow rate was not a significant factor in terms of advancing age. Furthermore, regularity indicated a significant difference in the following: 1) /pʌ/, /kʌ/ and /pʌtʌkʌ/ in syllable duration; 2) /kʌ/ duration in the gap between syllables. In conclusion, articulatory coordination is reduced with the onset of aging. In particular, /kʌ/ would be a sensitive task for articulatory coordination.ope

Word Lexicality- and Regularity-Dependent Alexia in Alzheimer’s Disease

Objectives : Despite a great deal of observation on subsequent alexia for Hangeul due to Alzheimer's disease (AD), there is a paucity of research on alexia in Korean AD patients. The purpose of this study is to identify characteristics of alexia of AD according to word lexicality and regularity. Methods : AD patients under GDS 3–6 on the Global Deterioration Scale and NE (normal elderly) groups of 20, were to read aloud three word types (regular words, irregular words, nonwords). Results : The findings revealed that the AD group had significantly higher error frequency when reading regular and irregular words and nonwords compared with the NE group. In addition, there were lexicality and regularity effects in the AD group. From the error analyses of the AD group reading irregular words, visual error was the most frequent, followed by regularization and misapplication of phonological rules. Conclusion : Unsurprisingly, AD patients using Hangeul manifested diverse word classification errors. This research is noteworthy in that it is the first study on the AD subject group reading Hangeul.ope

요양병원의 언어치료 현황

Objectives: To examine and compare the present situations of long-term care facilities regarding the services of speech and language therapy (SLT). Methods: Phone interviews across Korea were conducted with 1,233 hospitals that were established before October 2013 and were still operating as of March 2014. Whether the long-term care facilities were providing SLT services was examined and analyzed according to the region, the size of the facilities, existence of certification from an institution, and the presence of physiatrists. Furthermore, the working conditions of staff providing SLT including speech and language therapists were thoroughly examined. Results: The SLT services were dependent on regional factors. More than half of the facilities did not include SLT as a part of their services. Also, the use of SLT varied according to the size of the facilities. Bigger hospitals tended to have a higher percentage of language therapy implementation. Institutions certified by the Ministry of Health and Welfare of Korea and the Korea Institute for Healthcare Accreditation were more likely to provide SLT services. SLT services were provided more often when a physiatrist was present. Workers providing SLT differed depending on the region. Speech and language therapists were more likely to work full-time rather than part-time. Conclusion: This study shows the present state and availability of SLT at long-term care facilities, emphasizing the necessity of the service, and providing the basis for future studies.ope

우리나라 언어치료사의 핵심역량

Objectives: This study was aimed to survey what are perceived to be the core capacities of speech-language pathologists (SLPs). Methods: One hundred and fifty SLPs were surveyed with a questionnaire of 43 items based on the occupational and internal capacities by O*NET. We investigated the importance and performance/possession standards of the capacities, and explored the differences of capacities depending on the organization, experience and education. In addition, the priorities of SLPs in Korea and those in the United States were compared. Results: Firstly, importance of core capacities was rated higher than performance/possession standards for all 43 capacities. Secondly, when examining the discrepancies of SLP capacities in different organizations, the importance of 6 capacities and the performance/possession standards of 7 capacities were the highest for SLPs in hospital. Thirdly, when examining the discrepancies by experience, the importance of 2 capacities and the performance/possession standards of 7 capacities were the highest for those with 5 or more years of experience. Fourthly, when examining the discrepancies by education, the importance of 3 capacities and the performance/possession standards of 6 capacities were greater for those with degrees in graduate school or higher education. Fifthly, in comparing the priorities of SLP in Korea and those in the United States, the 13 capacities in Korea were relatively higher.ope

Development of Short Form of the Korean Version- the Boston Naming Test (K-BNT-15) Based on Item Response Theory

Impaired naming difficulty is common in normal elderly as well as in patients with neurological impairment. The 60-item Korean version-Boston Naming Test(K-BNT) is one of the most commonly used test for measuring confrontational naming ability. However, age-related cognitive decline may make the elderly difficult concentrating during the 60-item test, therefore, item reduction of the K-BNT would improve test validity and reliability. Thus, the purpose of this study was to develop a short form of the K-BNT based on Item Response Theory(IRT). Considering item-fit index, sex factor, and item difficulty through Rasch analysis, the 15-item K-BNT(i.e., K-BNT-15) was developed. Via administration of the K-BNT-15, we observed age-related decline in naming ability and significantly different performance between the normal elderly and patients with mild cognitive impairment. This study demonstrates the utility of IRT for developing a short-form language evaluation tool. The K-BNT-15 can be effective as a language screening tool to differentiate between normal aging and pathological diseases.ope

Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study

Background: Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults. Objective: The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults. Methods: We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant's progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention. Results: Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed. Conclusions: Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted. International registered report identifier (irrid): RR2-10.2196/19585.ope

Effect of Daily Communication Behaviors on Cognitive and Language Abilities of the Elderly

Purpose: The International Classification of Functioning, Disability, and Health can be utilized to measure individual health. Although ‘activity’ is one of the components of health, no studies have investigated the frequency of participation of the elderly in daily communication activities, such as talking, reading, and writing. We examined the daily communication behaviors of normal elderly subjects and their effects on cognitive and language test performance. Method: Normal elderly subjects (n = 456) over 60 years old completed a questionnaire on how often they thought that they talked/read/wrote in their daily lives. Also, they were administered the Korean Mini-Mental State Examination, Controlled Oral Word Association Test, Short Form of the Korean version-the Boston Naming Test, and Sentence Comprehension Test. Results: About 50% of the participants reported that they seldom talked, read, and/or wrote daily. The more frequently that the participants reported daily talking, reading and writing, the better they performed on cognitive and/or language tests. Daily writing influenced the test results the most, which suggested that writing behavior was closely related to all four cognitive/ language tests. Conclusion: These results suggested that daily active communication behaviors play major roles in the cognitive and language abilities of the elderly.ope

Language Profiles of Transcortical Aphasia

BACKGROUND: The term "transcortical aphasia" is applied to primary lesions not involving the receptive and expressive language areas, but rather the areas connected to the association cortex. By definition, patients with transcortical aphasia can repeat what they have heard, but they have difficulty producing spontaneous speech or understanding speech. This paper reports the clinical features of stroke patients with transcortical aphasia to delineate the language profiles of its subtypes. METHODS: Eighty patients with stroke were divided into three subtypes of transcortical aphasia: transcortical sensory aphasia, transcortical motor aphasia, and mixed transcortical aphasia. A Korean version of the Western Aphasia Battery was used to compare the subdomains of language ability among the three groups. RESULTS: The patients showed a relatively preserved repetition ability, but the performances in repetition and generative naming, and the aphasia quotient were highest in the transcortical sensory aphasic group, followed by the transcortical motor aphasic and mixed transcortical aphasic groups. CONCLUSIONS: The present study provides detailed information on the language profiles of the three subtypes of transcortical aphasia, which can be differentiated based on the aphasia quotient and generative naming scores.ope

Characteristics of Tongue Pressures Based on Swallowing Tasks in Korean Healthy Older Adults

Purpose The purpose of this study was to investigate tongue pressures of the elderly as a function of oral swallowing in swallowing tasks and tongue bulb locations. Methods Tongue pressures were compared between 2 locations (left vs. right) and also among 3 locations (anterior, medial, and posterior) of the tongue using the Digital Swallowing Workstation tongue bulb manometry system (KayPENTAX) in 20 young adults and 20 healthy older adults during dry swallow and 5 mL water swallow. Results Swallowing pressures significantly differed by task with higher pressure in dry swallow than in 5 mL water swallow. Older adults demonstrated significantly reduced tongue pressures during dry swallow than did young adults, whereas no group differences were observed during 5 mL water swallow. While no differences were found between the left and right of the tongue in either group, significantly greater tongue pressures were noted in the anterior compared with the middle or posterior portions. Furthermore, a negative relationship between tongue pressure and the Dysphagia Handicap Index was seen in older adults during dry swallow. Conclusion Age-related differences in terms of tongue pressures were evident only during dry swallow with a decline of the anterior tongue pressure amplitude. This study is significant in that it delineated the task and tongue bulb location-specific performance of swallowing in older adults.ope